From 2009-10 throughput has been measured in attendances. This was as a result of a drive to standardise coding practice across England. This answer therefore presents average attendances, rather than average fractions. A conversion factor of 1 fraction to 0.87 attendances has been used.
The average number of attendances per machine (linear accelerator) in England has been documented by the National Audit Office and is attached to this response.
The average number of attendances per machine in England (2013-14) was 7,084 attendances each year; using the conversion methodology this equates to around 8,143 fractions.
However, a number of factors impact on the average attendances for radiotherapy, chief amongst these are:
- The availability of a new generation of radiotherapy equipment. This is already installed in some departments across England and offers the opportunity to both increase the number of patients that can be treated per hour and also expand access to more innovative treatments.
- Complexity of treatments required coupled with changing clinical practice. Emerging evidence suggests that delivering fewer fractions, and therefore attendances, produces clinically equivalent outcomes.
- Changing population demographics. An ageing population, with increasing levels of co-morbidity, will require longer treatment times. This has potential to reduce the average attendance figure.
NHS England, working with the Radiotherapy Clinical Reference Group, are planning to build on an earlier assessment of radiotherapy demand and capacity for England by considering aspects such as innovative treatments, stock of equipment and how need differs across different localities. This national overview will enable commissioners to make certain that the right services are in the right places to meet future demands, including innovative forms of radiotherapy.